All that glisters is not COVID: Low prevalence of seroconversion against SARS-CoV-2 in a pediatric cohort of patients with chilblain-like lesions

Abstract

a della salute e della Scienza, Regina Margherita, Children's Hospital, Turin (TO), Italy c ; Laboratorio di Microbiologia e virologiaeAOU Maggiore della Carit a di Novara (NO), Italy d ; Pediatric and Pediatric Emergency Unit, Children's Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria (AL), Italy g ; and Department of Pediatrics, Ospedale Castelli Verbania (VB). h Funding sources: None.

COVID toes: where do we stand with the current evidence?

“…However, due to lack of specificity, these immunostainings should be interpreted with caution (Baeck et al, 2020b;Ko et al, 2020). -Conversely, RT-PCR and anti-SARS-CoV-2 serology were mostly negative (Baeck et al, 2020c;Caselli et al, 2020;Colonna et al, 2020;Denina et al, 2020;El Hachem et al, 2020;Freeman et al, 2020b;Garcia-Lara et al, 2020;García-Legaz Martínez et al, 2020;Le Cleach et al, 2020;Lesort et al, 2020;Mahieu et al, 2020;Neri et al, 2020;Rizzoli et al, 2020;Roca-Ginés et al, 2020;Rouanet et al, 2020;Stavert et al, 2020). Negative RT-PCR on nasopharyngeal swabs could suggest that chilblains are a late symptom of COVID-19.…”

Chilblains-Like Lesions in Pediatric Patients: A Review of Their Epidemiology, Etiology, Outcomes, and Treatment

“…Among studies reporting medication use, 31 patients either did not take medications or had been on stable doses for at least a month before the appearance of chilblains-like lesions ( 12 , 13 , 32 ). One patient had received acetaminophen intermittently around the time of lesion onset, and one patient had recently started ferric sulfate ( 41 ).…”

“…Desquamation was reported in seven cases, and in 20 cases, desquamation, peeling, scabs, and scale were reported together (11, 22-24, 26, 33, 34). Less common findings included crusts (14), acrocyanosis (13), hyperhidrosis (10), livedo or livedolike (8), acrorhigosis (7), pulpitis (7), eccrine hidradenitis-like (6), telangiectasia (4), acrocholosis (3), urticaria (3), pustules (3), erythema nodosa (2), targetoid (2), cheilitis (1), cyanotic lesions (1), scale (1), and petechiae (1, 10, 17, 19-21, 26, 28, 40, 43, 47, 48, 51, 54). In 65 cases, the rash morphology was unspecified (11).…”

Skin Manifestation of SARS-CoV-2: The Italian Experience

“…In December 2020, Quaglino et al described a case of different skin manifestations present in the same patient over different time periods, suggesting two different pathogenetic hypotheses potentially responsible [ 49 ]. However, the possible correlation between chilblain-like skin lesions and COVID-19 is still a matter of debate, as evidenced by the work of Denina et al [ 50 ].…”